Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13519 | Date 15/09/2025 |
| Token No | SM/25-26/2079 18/09/2025 | Serial | 002 |
| Patient Name | Mr. JAYANTA DUTTA | Contact No | 9836087108 |
| Address | 36 KASHI DOCTOR LANE | Age | 57 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||